Valuing Health Conditions - Insights from Happiness Surveys across Countries and Cultures

This paper assesses the effects of different health conditions on happiness. Based on a large data set for Latin America, the effects of different conditions are examined across age, gender, and income cohorts. Anxiety and pain have stronger effects than physical problems, likely because people can adapt better to one-time shocks than to constant uncertainty. The negative effects of health conditions are very large when compared to the effects of income on happiness. While higher peer income typically elicits envy, better peer health provides positive signals for life and health satisfaction. Nonetheless, health norms vary widely across countries. The results suggest that the life satisfaction approach applied to surveys of health may contribute to better health expenditure and policy decisions.Happiness, Health economics, Public policy, Surveys

Valuing Health Conditions - Insights from Happiness Surveys across Countries and Cultures

This paper assesses the effects of different health conditions on happiness. Based on a large data set for Latin America, the effects of different conditions are examined across age, gender, and income cohorts. Anxiety and pain have stronger effects than physical problems, likely because people can adapt better to one-time shocks than to constant uncertainty. The negative effects of health conditions are very large when compared to the effects of income on happiness. While higher peer income typically elicits envy, better peer health provides positive signals for life and health satisfaction. Nonetheless, health norms vary widely across countries. The results suggest that the life satisfaction approach applied to surveys of health may contribute to better health expenditure and policy decisions

The matrix revisited: a bird's-eye view of marine ecosystem service provision

The marine environment provides a range of ecosystem services and benefits for society. A previous study in Marine Policy (Potts et al., 2014) advocated a matrix approach to demonstrate the relative degree of ecosystem service provision from habitats and species within UK Marine Protected Areas (MPAs), but excluded seabird species in its assessment. Despite the number of existing UK MPAs designated specifically for individual seabird species and/or seabird assemblages, and the fact that seabird species have long been used as policy-relevant indicators for the monitoring and management of the marine environment, as yet little research has focussed on the direct role of seabird species in the provision of ecosystem services and how these are captured for marine spatial planning purposes in the context of MPAs. Building on the matrix approach, this paper develops and populates a matrix to illustrate the relationship between key UK breeding seabird species and their relative contribution to the delivery of intermediate ecosystem services and goods/benefits. The original matrix approach has been strengthened to include the development and testing of a set of rules for combining multiple matrices. Confidence scores relating to the underlying evidence base are built into the matrix to provide an illustration of the current understanding and to identify current gaps in evidence. Following a sense check by external seabird experts the matrix is applied in the context of four existing UK MPA case study sites. Further developments and applications of the seabird matrix are discussed within the context of wider marine management

A model of co-facilitation for supporting group coaching-supervision

This article presents a model of how two coaching supervisors work together when delivering cofacilitated group coaching supervision. The model consists of three layers. The first layer concerns how they manage the task of group supervision. The second layer articulates the tensions that exist in the relationship between the two supervisors and how they use this creatively to the benefit of their groups. The final and third layer attempts to articulate the energies that are created amongst the group. This model is not presented as a prescription of how to work – rather it is a deconstruction of how these supervisors work. Whilst borne out of coaching supervision work the model could also be applied in other contexts – for example facilitation and training. The authors welcome input from other practitioners to both test and build their current thinking

Workforce Policy and Care Quality in English Long-term Elder Care

In this article, we explore workforce policy and its potential to improve care quality in English long-term elder care. Using large, secondary sector datasets, we analyze relationships between care quality and the skill development practices prescribed by workforce policy, care quality, and a wider set of employment practices. We demonstrate that the latter is more likely to improve care quality than skill development alone. We further demonstrate that both skill development/care quality and employment practice/care quality relationships are stronger in the statutory than the independent sector. Our findings challenge the effectiveness of workforce policy in two ways. First, it may be too narrowly focused on skill development at the expense of wider employment practice. Second, it may not be effective in improving care quality when outsourcing care ostensibly to improve it leads, particularly in the independent sector, to cost-based commissioning that mitigates against robust employment practice

Toward Designing the Optimal Total Cavopulmonary Connection: an In Vitro Study

Background. Understanding the total cavopulmonary connection (TCPC) hemodynamics may lead to improved surgical procedures which result in a more efficient modified circulation. Reduced energy loss will translate to less work for the single ventricle and although univentricular physiology is complex, this improvement could contribute to improved postoperative outcomes. Therefore to conserve energy, one surgical goal is optimization of the TCPC geometry. In line with this goal, this study investigated whether addition of caval curvature or flaring at the connection conserves energy. Methods. TCPC models were made varying the curvature of the caval inlet or by flaring the anastomosis. Steady flow pressure measurements were made to calculate the power loss attributed to each connection design over a range of pulmonary flow splits (70:30 to 30:70). Particle flow visualization was performed for each design and was qualitatively compared to the power losses. Results. Results indicate that curving the cavae toward one pulmonary artery is advantageous only when the flow rate from that cavae matches the flow to the pulmonary artery. Under other pulmonary flow split conditions, the losses in the curved models are significant. In contrast, fully flaring the anastomosis reduced losses over the range of pulmonary flow splits. Power losses were 56% greater for the curving as compared to flaring. Fully flaring without caval offset reduced losses 45% when compared to previous models without flaring. If flaring on all sides was implemented with caval offset, power losses reduced 68% compared to the same nonflared model. Conclusions. The results indicate that preferentially curving the cavae is only optimal under specific pulmonary flow conditions and may not be efficient in all clinical cases. Flaring of the anastomosis has great potential to conserve energy and should be considered in future TCPC procedures